ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Friday, August 16, 1996 TAG: 9608160070
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: LONDON
SOURCE: Associated Press
NOTE: Above
ALZHEIMER'S DISEASE may be warded off in women who take the hormone well into menopause.
Women who take estrogen long after menopause appear to be at least one-third less likely than others to develop Alzheimer's disease, one of the most dreaded afflictions of old age, according to a study published Friday.
``This is one more piece of evidence that this disease is not going to be an undefeatable enemy, that we will slow it down,'' said Dr. Steven DeKosky, a vice chairman of America's Alzheimer's Association and director of Alzheimer's research at the University of Pittsburgh.
The Columbia University study, described in this week's edition of The Lancet, a British medical journal, was the first to involve roughly equal numbers of elderly white, black and Hispanic women.
Hormone replacement therapy has been most commonly used by white women who are better-educated and more affluent, factors believed to put them at lower risk for Alzheimer's than poorer minority women anyway. But the effects of taking estrogen proved to be the same in each ethnic group.
``That was when we knew we had something,'' Dr. Richard Mayeux, the main author of the report, said in a telephone interview from his office at Columbia-Presbyterian Medical Center.
``What is exciting is that we now have the most convincing evidence to date that estrogen may have this effect, and it warrants clinical trials.''
Estrogen replacement carries risks as well as benefits. It has been shown to prevent heart disease and bone deterioration, and it may guard against colon cancer - and now Alzheimer's. But some evidence indicates it may cause a 50 percent increase in breast cancer.
The new estrogen results come a day after an encouraging report from Brigham and Women's Hospital in Boston, which said post-menopausal women may ward off heart disease as effectively with a commonly prescribed combination of estrogen and progestin as with straight estrogen.
Because estrogen used alone was known to carry an increased risk of uterine cancer, doctors commonly prescribed the hormone combination. They knew it eliminated the cancer risk but were uncertain whether it offered heart benefits. The Boston study, based on 16 years' research with 59,337 nurses, showed that estrogen-progestin pills protected the heart as well as estrogen alone.
The five-year Columbia study monitored 1,124 women with an average age of 74 in the Upper Manhattan neighborhoods of New York City. It found that those who had used estrogen for a decade or more were 30 percent to 40 percent less likely to develop the mind-destroying Alzheimer's disease.
Other scientists hailed the Columbia findings as an important step in growing evidence that the female hormone, production of which drops sharply after menopause, is a key weapon against Alzheimer's.
Scientists say they originally were alerted to the possible link between hormone and disease by the fact that men, who are 10 percent to 15 percent less likely to develop Alzheimer's than women, convert testosterone into estrogen into later life.
Dr. Neil Buckholtz of the U.S. National Institute for Aging said the Columbia results underlined the need for more studies with careful controls.
``It does seem, based on this, that there is a reduced risk of Alzheimer's disease for all post-menopausal women who take hormone replacement therapy,'' he said.
In the Manhattan group, 15 percent, or 167, of the women developed Alzheimer's disease during the study. That percentage was about average, but the victims included far fewer estrogen users. Furthermore, the disease showed up much later for women who were using replacement estrogen and still developed Alzheimer's.
On average, 8.4 percent of the women who did not take estrogen developed Alzheimer's disease each year, compared with 2.7 percent of the women who were taking the hormone. The study also found that the longer a woman had taken estrogen, the greater the protection against Alzheimer's.
Alzheimer's disease, the most common form of dementia, begins with memory loss and goes on to destroy memory and mental and bodily functions. It affects about 15 percent of people over 65, and nearly half of those past 85.
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